Organization
MARY S JUNG MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY SUN JUNG M.D. (PRESIDENT)
(714) 538-8556
Entity
Organization
Contact information
Practice address
1506 E CHAPMAN AVE, ORANGE, CA 92866-2231
(714) 538-8556
(714) 538-1082
Mailing address
1506 E CHAPMAN AVE, ORANGE, CA 92866-2231
(714) 538-8556
(714) 538-1082
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A73312
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A733120
—
CA
01
—
05D1058795
CLIA
CA
01
—
A73312
MEDICAL LICENSE
CA
Enumeration date
09/13/2006
Last updated
07/31/2014
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